A Biodegradable Tissue Adhesive for Post-Extraction Alveolar Bone Regeneration under Ongoing Anticoagulation—A Microstructural Volumetric Analysis in a Rodent Model

International Journal of Molecular Sciences, vol. 25, pp. 4210

Abstract

In addition to post-extraction bleeding, pronounced alveolar bone resorption is a very common complication after tooth extraction in patients undergoing anticoagulation therapy. The novel, biodegenerative, polyurethane adhesive VIVO has shown a positive effect on soft tissue regeneration and hemostasis. However, the regenerative potential of VIVO in terms of bone regeneration has not yet been explored. The present rodent study compared the post-extraction bone healing of a collagen sponge (COSP) and VIVO in the context of ongoing anticoagulation therapy. According to a split-mouth design, a total of 178 extraction sockets were generated under rivaroxaban treatment, of which 89 extraction sockets were treated with VIVO and 89 with COSP. Post-extraction bone analysis was conducted via in vivo micro-computed tomography (µCT), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDX) after 5, 10, and 90 days. During the observation time of 90 days, µCT analysis revealed that VIVO and COSP led to significant increases in both bone volume and bone density (p ≤ 0.001). SEM images of the extraction sockets treated with either VIVO or COSP showed bone regeneration in the form of lamellar bone mass. Ratios of Ca/C and Ca/P observed via EDX indicated newly formed bone matrixes in both treatments after 90 days. There were no statistical differences between treatment with VIVO or COSP. The hemostatic agents VIVO and COSP were both able to prevent pronounced bone loss, and both demonstrated a strong positive influence on the bone regeneration of the alveolar ridge post-extraction.

Authors 8

1. Marius Heitzer corresponding Aachen Department of Oral and Maxillofacial Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany

2. Philipp Winnand Aachen Department of Oral and Maxillofacial Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany

3. Mark Ooms Aachen Department of Oral and Maxillofacial Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany

4. Zuzanna Magnuska Aachen Institute for Experimental Molecular Imaging

   RWTH Aachen University

   Affiliation as printed

   Institute for Experimental Molecular Imaging, RWTH Aachen University, Forckenbeckstraße 55, 52074 Aachen, Germany

5. Fabian M. Kiessling Aachen Institute for Experimental Molecular Imaging

   RWTH Aachen University

   Affiliation as printed

   Institute for Experimental Molecular Imaging, RWTH Aachen University, Forckenbeckstraße 55, 52074 Aachen, Germany

6. Eva Miriam Buhl Aachen Institute for Pathology, Electron Microscopy Facility

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Institute for Pathology, Electron Microscopy Facility, University Hospital RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany

7. Frank Hölzle Aachen Department of Oral and Maxillofacial Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany

8. Ali Modabber Aachen Department of Oral and Maxillofacial Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany